首页> 中文期刊> 《中国全科医学》 >肠型胃癌和弥漫型胃癌的临床特点及预后研究

肠型胃癌和弥漫型胃癌的临床特点及预后研究

摘要

Objective To discuss clinical characteristics and prognosis of intestinal-type and diffuse-type gastric cancer.Methods A total of 392 patients with gastric cancer receiving operative treatment in the surgical ward of Heping Hospital Affiliated to Changzhi Medical College from January 1st 2007 to December 30th 2015 were selected.Among them,231 (58.9%) were intestinal type and 161 (41.1%) were diffuse type.The epidemiological questionnaire gastric cancer was established.The trained professionals according to unified standards collected the information of patients with gastric cancer.Their basic situation (gender,age,height,body mass,educational level,marital status,blood type,helicobacter pylori infection,family history of cancer);lifestyle and habits (smoking,drinking,eating speed,eating hot food,eating Chinese sauerkraut/pickles/preserved vegetables,eating fried foods);and pathological diagnosis and clinical staging were included in the collected information.The telephone follow-up of patients was made to inquire about survival by people having master degree or above in central lab of the hospital,and would be conducted until December 30th 2015.Results There were no significant differences in gender,body mass index (BMI),educational level,marital status,blood type,helicobacter pylori infection and history of cancer between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P>0.05).There were significant differences in age between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P<0.05).There were significant differences in smoking and drinking between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P<0.05).There were no significant differences in eating speed,eating hot food,eating Chinese sauerkraut/pickles/preserved vegetables,eating fried foods between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P>0.05).There was no significant difference in T phase and M phase between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P>0.05).There was significant difference in N phase between patients with intestinal-type cancer and patients with diffuse-type gastric cancer (P<0.05).Three hundred and forty patients with gastric cancer had completed the followed up,the follow-up rate was 86.7%.By the end of follow-up,the survival rate of patients with intestinal-type gastric cancer was 66.5% (129/194),the median survival time was 24 months;and the survival rate was 52.7% (77/146) in patients with diffuse-type gastric cancer,and the median survival time was 18 months.The survival curves between patients with intestinal-type gastric cancer and patients with diffuse-type gastric cancer were significantly different (P<0.05).Conclusion The clinical manifestations and prognosis of Lauren classification were different.Lauren classification plays a decision-making role in the treatment and prevention of gastric cancer.%目的 探讨肠型胃癌和弥漫型胃癌的临床特点及预后.方法 选取2007-01-01至2015-12-30在长治医学院附属和平医院外科病房手术治疗的胃癌患者392例,其中肠型231例(58.9%),弥漫型161例(41.1%).建立胃癌流行病学调查问卷,并由经过培训的专业人员按统一标准采集胃癌患者信息,包括基本情况(性别、年龄、身高、体质量、文化程度、婚姻状况、血型、幽门螺杆菌感染、肿瘤家族史)、生活方式及习惯(吸烟、饮酒、进食速度、进食烫食、进食酸菜/咸菜/泡菜、进食油炸食品)及病理诊断与临床分期等;并由本院中心实验室具有硕士及以上学历人员对患者进行电话随访,询问生存情况,随访截至2015-12-30.结果 肠型与弥漫型胃癌患者性别、体质指数(BMI)、文化程度、婚姻状况、血型、幽门螺杆菌感染、肿瘤家族史比较,差异无统计学意义(P>0.05);肠型与弥漫型胃癌患者年龄比较,差异有统计学意义(P<0.05).肠型与弥漫型胃癌患者吸烟、饮酒比较,差异有统计学意义(P<0.05);肠型与弥漫型胃癌患者进食速度、进食烫食、进食酸菜/咸菜/泡菜、进食油炸食品比较,差异无统计学意义(P>0.05).肠型与弥漫型胃癌患者T期、M期比较,差异无统计学意义(P>0.05);肠型与弥漫型胃癌患者N期比较,差异有统计学意义(P<0.05).340例胃癌患者完成随访,随访率为86.7%;截至随访日期,肠型胃癌患者生存率为66.5%(129/194),中位生存时间为24个月;弥漫型胃癌患者生存率为52.7%(77/146),中位生存时间为18个月.肠型与弥漫型胃癌患者生存曲线比较,差异有统计学意义(P<0.05).结论 不同Lauren分型胃癌临床特点和预后不同.Lauren分型在胃癌治疗及预防中起一定的决策作用.

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